indication for adding imipenem in acute pancreatits - USMLE Forums
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Old 11-10-2012
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Pancreas indication for adding imipenem in acute pancreatits

is it just necrosis on CT scan or 30 % necrosis ?

IMO, just necrosis. and when > 30 %, CT guided bx is done. thoughts?
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Old 11-10-2012
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You would add imipenem or any other wide spectrum Abs if you have necrotic pancreatitis that is greater than 30% with infection; also dont forget that debridement would be done as well.
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More than 30% necrosis----> Add Imipenam (to prevent infection)

More than 30% necrosis with deterioration----> Guided Needle biopsy (to rule out infection)

Infected necrosis in a stable patient------> Percutaneous drainage

Infected necrosis with clinical/biochemical deterioration------> Surgical Debridement
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